Provider Demographics
NPI:1689068488
Name:SHANI, HAGIT (MD)
Entity Type:Individual
Prefix:DR
First Name:HAGIT
Middle Name:
Last Name:SHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 NETHERLAND AVE
Mailing Address - Street 2:APT 1706
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4801
Mailing Address - Country:US
Mailing Address - Phone:201-290-9454
Mailing Address - Fax:
Practice Address - Street 1:1695 EASTCHESTER RD
Practice Address - Street 2:SUITE 301
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2374
Practice Address - Country:US
Practice Address - Phone:718-405-8150
Practice Address - Fax:718-405-8154
Is Sole Proprietor?:No
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program